The Beeches

Updated 14 June 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience’s area of expertise was in older people and dementia care.

Service and service type:

The Beeches is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. The Beeches can accommodate up to 54 people across four units over two floors.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This was an unannounced, comprehensive inspection.

What we did:

Before the inspection we reviewed the information we held about the service. This included information from other agencies and statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used all this information to decide which areas to focus on during our inspection. The provider completed a Provider Information Return. This is key information about the service, what they do well and improvements they plan to make. This information helps support our inspections.

During the inspection:

We spoke with 11 people who used the service and spent time observing the care and support people received. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with one relative of a person living at the home. We also spoke with the regional support manager, the registered manager, the administrator, a team leader, four care staff, a housekeeper and the activity lead. We reviewed a range of records. These included eight care plans and associated risk assessments, a staff file and records relating to the management of the service.

After the inspection:

The registered manager sent some additional evidence in response to feedback provided at the end of the inspection.

Updated 14 June 2019

About the service: The Beeches is a residential care home that provides personal and nursing care for up to 54 older people, some of whom are living with dementia. At the time of the inspection, 47 people were living at the home. The Beeches is divided into four separate units in one building: Squirrels, Foxes, Dormouse and Woodpecker.

People’s experience of using this service:

People were not protected from the risk of infection. Paper containing faecal matter had been left on top of the cistern in one toilet and a bedsheet was stained with faecal matter. Continence pads were not stored safely.

People’s care needs were recorded, as were their preferences, likes and dislikes in most cases. However, activities were not planned based on people’s interests, although there was a programme of activities every day. Information was not presented in an accessible format in line with people’s communication needs. Care plans lacked detail in some cases on how staff should support people’s specific needs.

People did not always feel there were enough staff to support them promptly when they needed help. One person said, “There are not enough staff and it puts me off calling them. I don’t want to overwork them, they do so much”. We have made a recommendation in relation to the deployment of staff.

On the day of inspection it was not clear who had overall management of the home. People had mixed views about the management. One person said, “We have two or three [managers], but they are mostly in their offices. You can go and see them, but they should be out here seeing us”.

People were positive about the care they received and staff were friendly, kind and caring. People were treated with dignity and respect and encouraged to make decisions about their care. A relative said, “We are always made welcome. They know we travel a distance and there’s always a drink and we can eat if we want to. We couldn’t be happier”.

People told us they felt safe living at the home. Their risks had been identified and assessed appropriately with guidance for staff on how to mitigate risk. Medicines were managed safely.

People were happy with the food on offer and said they had a choice of menu. Special diets were catered for. People had access to a range of healthcare professionals and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People and their relatives were asked for their feedback through questionnaires and results were overall positive. Residents’ meetings took place and suggestions were listened to and acted upon. Staff felt supported in their roles and completed a range of training to carry out their responsibilities. They had the skills, knowledge and experience to deliver effective care.

Rating at last inspection: At the last inspection, this service was rated as Good (published in April 2018).

Why we inspected: We were required to inspect this service within 12 months of the last inspection because of a breach of regulation. The provider sent us a plan after the last inspection which outlined the actions they proposed to take to address the issues of concern. This inspection took place to check on the improvements made and in line with CQC scheduling guidelines for adult social care services.

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We will review the service in line with our methodology for ‘Requires Improvement’ services.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk